Psoriasis and Tdap: Is It Safe? - Verywell Health

Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: diphtheria, tetanus, and acellular pertussis. The Tdap vaccine is given at ages 11 or 12, to older teens, and to adults who have not had the booster for pertussis coverage. Pregnant people should also take the Tdap vaccine in their third trimester.  

People with the autoimmune skin condition psoriasis can safely take the Tdap vaccine. Because of their compromised immune systems, they should be up to date on their Tdap vaccine and other vaccines for preventable conditions that put them at risk for severe illness and death from infections.  

This article covers the safety and effectiveness of the Tdap for people with psoriasis, side effects and risks, who should take this vaccine, and more.

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Is the Tdap Safe and Effective for People With Psoriasis?

Tdap vaccination offers the best protection against diphtheria, tetanus, and acellular pertussis. These conditions have the following health impacts:

• Tetanus causes pain and stiff muscles and can lead to serious health problems, including the inability to open your mouth and trouble with swallowing or breathing, and can lead to death.
• Diphtheria causes problems with breathing and can lead to heart failure, paralysis, or death.
• Pertussis, also known as whooping cough, can cause severe and uncontrollable coughing, breathing troubles, and eating and drinking difficulties. It can be serious in babies and young children and lead to pneumonia, brain damage, and death. In teens and adults, weight loss, bladder control problems, fainting, and rib fractures from severe coughing are common. 

Diphtheria and pertussis can spread from person to person, while tetanus enters the body through a wound or cut.

The Tdap vaccine provides pertussis protection for 7 out of every 10 people who receive it. There is a decrease in effectiveness every year that follows. Around 3 or 4 people out of 10 are fully covered for pertussis four years after getting the Tdap.  

Getting vaccines when you have psoriasis is important because the medications you take to treat psoriasis can increase your risk for infections and other diseases that vaccines, including Tdap, can prevent.

Tdap is an inactive vaccine made from dead bacteria and their inactivated toxins. These cannot make a person sick. People with psoriasis can take vaccines made from dead bacteria and their inactivated toxins without any problems.

Avoiding Live Vaccines

Your healthcare provider might recommend avoiding live vaccines if you are being treated with corticosteroids or biologic drug therapies, which suppress the immune system.

Examples of live vaccines are MMR (measles, mumps, rubella combined vaccine), varicella (for chicken pox), rotavirus, and the nasal spray flu vaccine. Talk to your healthcare provider to see if live vaccines are safe for you.

Severe effects from Tdap vaccines for psoriasis are uncommon, although there have been some rare incidences of disease exacerbation (worsening) after vaccination. Any skin trauma can lead to a Koebner's reaction in the area of the trauma.

A Koebner's reaction, also called Koebner's phenomenon, describes the development of new skin lesions on body areas where a person hasn't previously experienced skin lesions. This triggering response is named after Heinrich Koebner, the scientist who discovered it in 1876. It is usually the result of some type of skin trauma.

In one 2013 study, researchers report that the Td vaccine, which only covers tetanus and diphtheria, induced the production of interleukin-6 (IL-6, a protein associated with an inflammatory response), stimulating Th17 cells that play a part in psoriasis development. This underlying disease trigger is rare, and the benefits that vaccines like Tdap and Td offer outweigh the risks.

Tdap Vaccines Are Safe

Millions of Americans have received Tdap vaccines safely. All vaccines go through extensive and rigorous testing, and they have been proven safe and effective across a wide-ranging population before approval for use. Monitoring and testing of safety and effectiveness continue long after vaccine approval.

Anyone who has ever had a life-threatening allergic reaction to the Tdap vaccine should avoid receiving the vaccine. People who have experienced a neurological disorder affecting the brain from a prior Tdap vaccine should also avoid getting further Tdap vaccines, including Td boosters.

Which Type Should People With Psoriasis Get?  

The Tdap vaccine is recommended for preteens to help boost their immunity after receiving a DTaP (diphtheria, tetanus, and acellular pertussis) in early childhood. Pregnant people should also consider the Tdap during the latter part of their pregnancy.  

Another version of the Tdap is called the Td vaccine, which can prevent tetanus and diphtheria. It is usually given as a booster dose every 10 years (or after five years if someone experiences a severe burn or dirty wound). The Td vaccine does not protect against pertussis. Td vaccine administration is the same as other vaccines.

The DTaP is given five times throughout a child's early years—at 2 months, 4 months, 6 months, 15 to 18 months, and 4 to 6 years of age. The DTaP is not given to children 7 years and older. The DT vaccine is similar to the Td vaccine but given to children under age 7 who should not take the pertussis part of the vaccine.

Are There Any Side Effects of Taking the Tdap Vaccine?

As with all vaccines, Tdap can cause side effects. Fortunately, the chance of experiencing a life-threatening allergic reaction is minimal. According to the Centers for Disease Control and Prevention (CDC), the dangers of pertussis, tetanus, or diphtheria outweigh most of the risks posed by the vaccine.

Mild side effects of the Tdap vaccine can include:

• Pain, redness, and swelling at the injection site
• Mild fever
• Headache
  
• Fatigue
  
• Gastrointestinal troubles, including nausea, vomiting, or diarrhea
• Muscle aches
• Swollen glands

Some people may experience other side effects, including arm swelling and high fever.  

While extremely rare, it is possible to have a severe allergic reaction, called anaphylaxis, to an ingredient in the Tdap vaccine. An allergic reaction to a vaccine usually occurs within minutes of receiving the dose.

Signs of a severe allergic reaction related to vaccination might include:

• Breathing difficulty, including wheezing
• Dizziness
• Hoarse voice
• High fever
• Hives (raised welts)
  
• Pale skin
• A rapid heartbeat
• Weakness

You should seek immediate medical care if you experience any of these signs after receiving the Tdap vaccine.

Risks of Diphtheria, Tetanus, and Acellular Pertussis for People With Psoriasis

Diphtheria, tetanus, and pertussis are serious bacterial infections that can lead to death. Getting vaccines is the best way to protect yourself and others from these infections, especially for people with psoriasis, whose immune systems are compromised.  

Studies have found that people with psoriasis have an increased risk of serious infections, including bacterial infections like diphtheria, tetanus, and pertussis. They also have an increased risk for hospitalization from severe infections and a higher risk for death from any kind of infection.

What Should People Avoid Before Taking Tdap

While there are no specific restrictions on food, beverages, medications, or activity before the Tdap vaccine, you should follow any instructions your healthcare provider gives you. the injection usually is given in the upper arm, so wear clothing appropriate for exposing this area.

You can get the Tdap vaccine along with other needed vaccines during the same visit, although they will be given with a different syringe and possibly in a different injection site on your body.

Where Does the Tdap Vaccine Come From?

Two Tdap vaccines are available in the United States: Adacel and Boostrix. Both contain inactivated forms of the toxins produced by the bacteria that cause diphtheria, tetanus, and pertussis.  

This means that the substances in the vaccine no longer produce the disease, but they trigger a response to create antibodies that give immunity against the toxins.

Where Can You Get a Tdap Vaccine?

You can get a Tdap vaccine at your healthcare provider's office or local pharmacy. You can get more information about the Tdap vaccine or search for a vaccine location through your local or state health department, the Food and Drug Administration (FDA), and the CDC website.

When Should You Take the Tdap Vaccine?

The Tdap vaccine is available to anyone ages 7 and up. Older children need to take the Tdap vaccine at around age 11 or 12. Adults should get another Tdap or a Td vaccine every 10 years.

Anyone who is pregnant should get the Tdap during their third trimester of pregnancy. Getting the Tdap in the third trimester can protect your newborn from whooping cough in the first few months of life.

Adolescents should receive a single dose. For pregnant people, one dose during the early part of the third trimester is recommended to protect newborns from pertussis.  

An adult who has never received Tdap should get a Tdap dose and a booster dose every 10 years (or five years if they experience a severe or dirty burn or wound). Adults who have had the Tdap vaccine should get one dose of Tdap or Td vaccine every 10 years. A Tdap vaccine can be given with other needed vaccines.  

Summary

The Tdap vaccine protects against three serious and life-threatening bacterial infections: tetanus, diphtheria, and pertussis. It is recommended for adolescents ages 11 to 12, adults who have never gotten the vaccine, and pregnant people.  

It is crucial for people with autoimmune conditions like psoriasis to take the Tdap vaccine because they have a higher risk for infection than others without the disease. Your healthcare provider can administer the vaccine or you can visit a local pharmacy to get the Tdap vaccine.

A Word From Verywell

Vaccines keep people safe from very dangerous diseases that would otherwise lead to hospitalization and death. Getting vaccinated for diphtheria, tetanus, pertussis, and other preventable conditions is especially important for people with psoriasis because of their increased risk for infection.

If you are concerned about experiencing a Koebner's reaction, you should avoid vaccination during an active psoriasis flare. Your treating dermatologist or primary healthcare provider can answer any questions or concerns about a specific vaccine or on how to get vaccinated safely with psoriasis.